Washington Report 052006

Date Published: 
May 2006
Original Author: 
Robert M. Fells
Original Publication: 
ICCFA Magazine

Groups discuss flu pandemic 

by ICFA General Counsel Robert M. Fells, Esq.
In late March, ICFA representatives participated in the two-day Fatality Management Pandemic Influenza Working Group Conference at Fort Monroe in Hampton, Virginia. Past President Robert A. Gordon Sr., CCFE, and General Counsel Robert M. Fells represented the association. Among the more than 40 participants were representatives from the National Funeral Directors Association, Cremation Association of North America, funeral service companies and numerous federal and state agencies, including as the Department of Homeland Security, the Department of Health and Human Services, D-MORT, the U.S. Red Cross, local police departments and medical examiners.
Attendees were welcomed by Army Maj. Gen. Bruce Davis, who said, "This conference presents the opportunity to bring members of the mortuary affairs community and other related subject matter experts within the federal, state, local and private sectors to focus on this potential challenge and help shape the way ahead with their recommendations. The work your group is doing in this area is difficult and complex; nonetheless, it is critical as our nation prepares for a possible pandemic influenza event."
The group received briefings on various histories of flu pandemics. In particular, a history of the Spanish Influenza that infected the United States in a series of waves during 1918-1919 was reviewed. Before the pandemic had run its course, 28 percent of Americans had become infected; the mortality rate was 2.5 percent. The mortality rate for previous flu epidemics had been less than 0.1 percent. The death rate for 15- to 34-year olds was 20 times higher than in previous years, and the flu killed more than 10 times the number of Americans killed in battle during World War I.
Conference attendees were divided into four working groups to develop action plans based on a fictional scenario of a flu outbreak affecting a certain percentage of the population, with different assumed fatality rates. The four groups were: 1. scene operations; 2. morgue operations, identification and planning; 3. family assistance centers; and 4. funeral services and final disposition. On the second day of the conference, each of the groups made a PowerPoint presentation detailing its recommendations and areas for future study. White papers discussing the recommendations of each working group are in the process of being drafted and should be available in the near future.
Though the conference dealt with the potential for any type of influenza pandemic, attention was focused on the so-called "bird flu." It is technically known as H5N1 Highly Pathogenic Avian Influenza, and is a viral respiratory infection that has afflicted some of the bird population overseas but has not mutated to infect humans. According to media reports, the approximately 100 known human cases involve people who handled infected birds without wearing protective gear.
To date, there has been no transmission of this disease from human to human. However, officials are concerned that over time the strain may mutate with other more common forms of influenza and thereby infect a large number of people. It is estimated that a potential infection of the U.S. bird population due to migratory patterns may be anywhere from six months to one year away. As a result, the federal government is working with state agencies and the private sector to implement action plans to respond to potential developments.
Recently, the London Sunday Times reported on a confidential British government report dated March 22 and titled, "Managing Excess Deaths in an Influenza Pandemic." The report contains a "prudent worst case scenario" suggesting that 320,000 could die in the UK if the H5N1 virus mutated into a form contagious to humans. The report states, "Even with ramping local management capacity by 100 percent, the prudent worst case of 320,000 excess deaths is projected to lead to a delay of some 17 weeks from death to burial or cremation."
ICFA members will be kept informed of the follow-up activities of the Pandemic Influenza Conference, including the posting of white papers on the ICFA Web site.